The positive impact of Strong and Stable Leadership. David Dalton Chief Executive

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1 The positive impact of Strong and Stable Leadership David Dalton Chief Executive

2 Leadership Mobilising the attention, resources and practices of others towards particular goals, values or outcomes. It requires: presence and visibility first hand knowledge of reality of front line learning from and remaining connected with those for whom you are responsible.

3 The Leadership Role Culture change and continual improvement comes from what leaders do: through their commitment, encouragement, compassion and modeling of appropriate behaviors.

4 Less than 8 CEOs had been in post longer than 10 years; and >50% had been in post less than 2 years Hoggett Bowers 2009 Compared with: average tenure of NHS consultant = 27 years Based on: Average age of acquiring CTT 36 years Average age of retirement of NHS consultant: men 63 women 64

5 Much is said about clinical and staff engagement, but why should people engage if they can t build a relationship built on trust and mutual respect? A high level competence generally associated with strategic leaders is cognitive complexity. This implies that strategic leaders have unusually rich cognitive maps permitting them to deal with more complex organisational and environmental challenges. This cognitive complexity is revealed particularly by how far into the future a leader is able to plan and influence. Therefore, the establishment and development of high quality, long term relationships is crucial to the strategic development of the organisation. Most senior people can deliver the tangibles, it s the ability of CEOs to deliver on relationships that separates the more successful leaders from the rest and of course, usually if you get this right the other deliverables fall into place.

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8 Spot the difference: A study of boards of high performing organisations in the NHS Naomi Chambers, Alison Pryce, Yanchao Li, Petra Poljsak Manchester Business School July 2011 Findings: found a positive link between high performing organisations and: CEOs being in post for longer than 4 years Aspiring NHS Chief Executives (CEOs) used to be warned that it was rare to find CEOs who were both bold and old, the implication being that if you wanted to make it through to retirement, don t put your head above the parapet.

9 What have I got to show for 13 years?

10 Where are we now? SRFT Results

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13 Recognise the Disconnected Hierarchy

14 Jack Silversin, DMD, DrPH Amicus, Inc Cambridge, Massachusetts

15 Structure Strategy Systems Shared Values CULTURE Culture Skills Style Staff

16 Key Themes Leadership - developing Clinical Leaders into new positions of responsibility - shop floor leadership Accountability -balancing power/responsibility with accountability Performance - Supporting high performance + assessment

17 Clinical Leadership Involvement CD/GM GM/CD Chair & MD Partnership What are the conditions for success? support, time, skills, capability decision making rights consequences for good/poor performance responsibility & accountability

18 Accountability Clinical Standards Integrated Responsibility Safety & Quality Financial Management Operational Performance

19 New Deal Doctors Give?? Actively engage in Quality Improvement Treat team members with respect Standardise evidence based practice Create value through better use of resources Doctors Get?? Inclusion in significant decisions Transparency of decisions and resource use Commitment to a well-run hospital Appreciation for contribution

20 Leadership and Engagement Clinical Leaders stepped down Development Programme and Assessment Appointment + new roles with Accountability Teamworking Aligned Contribution and Coaching

21 Connecting the Individual to their contribution to the Annual Plan

22 Accountability Extends to behaviour Respectful To colleagues, through teamwork To patients and customers, putting their interests before their own To the organisation, observing policies and procedures Accountable Have high standards of integrity and honesty Are open to change Use evidence of best practice Focus on the needs of patients Contribute to Safe, Clean, Personal care Provide care and services which are effective and reliable Provide services efficiently and without waste Continuous improvement Motivated to find solutions to problems Have a spirit of energy Are resourceful and can do Are comfortable with change

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25 Leadership at Salford Royal Leaders at all levels are crucial in creating the culture of care and compassion at Salford Royal. Strong and stable leadership has created the following model: Clarity of Purpose Aims & Values What, how much, when Assess & Measure Mindset Seek High Reliability Deep staff engagement Openness & Transparency Teamwork trumps hierarchy Behaviours Hear Patient voice & listen to Staff Visibility and Authenticity Signal Generator Defer to expertise Assessment and Feedback Adopt a coaching approach

26 Salford Royal s Leadership Framework Goals are crucial, but if leadership is not rooted in the relationships formed by agreeing a shared view on the following: Values & Aims Mindset Behaviours then you will never deliver the goals you have set.